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Does deep brain stimulation improve lower urinary tract symptoms in Parkinson's disease?
Author(s) -
Witte Lambertus P.,
Odekerken Vincent J. J.,
Boel Judith A.,
Schuurman P. Richard,
GerbrandySchreuders Lara C.,
de Bie Rob M. A.
Publication year - 2018
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23301
Subject(s) - medicine , nocturia , deep brain stimulation , parkinson's disease , subthalamic nucleus , lower urinary tract symptoms , urinary incontinence , overactive bladder , urinary urgency , post hoc analysis , parkinsonism , urinary system , urology , physical therapy , disease , prostate , alternative medicine , pathology , cancer
Aims To investigate whether deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) or the subthalamic nucleus (STN) improve lower urinary tract symptoms (LUTS) in advanced Parkinson's disease (PD). Methods An exploratory post‐hoc analysis was performed of specific LUTS items of questionnaires used in a randomized clinical trial with 128 patients (NSTAPS study). First, we compared scores on LUTS items at baseline and 12 months for the GPi DBS and STN DBS group separately. Second, we divided the group by sex, instead of DBS location; to assess a possible gender associated influence of anatomical and pathophysiological differences, again comparing scores at baseline and 12 months. Third, we reported on Foley‐catheter use at baseline and after 12 months. Results Urinary incontinence and frequency improved after both GPi DBS and STN DBS at 12 months, postoperatively, but this was only statistically significant for the STN DBS group ( P = 0.004). The improvements after DBS were present in both men ( P = 0.01) and women ( P = 0.05). Nocturia and urinary incontinence did not improve significantly after any type of DBS, irrespective of sex. At 12 months, none of the patients had a Foley‐catheter. Conclusions Urinary incontinence and frequency significantly improved after STN DBS treatment in male and female patients with PD. Nocturia and nighttime incontinence due to parkinsonism did not improve after DBS, irrespective of gender.